Is there a role for dual tracer imaging in detection of parathyroid disease
Avidity of Tl 201 (Tl) for pathological thyroid tissue could compromise the specificity of dual tracer imaging for parathyroid (PT) adenoma or hyperplasia. Within 24 hours of scheduled PT surgery, 17 patients were imaged with 5 mm pinhole collimator and gamma camera, and digital data acquired for sequential 5 min intervals as follows: initial image 4 hours after 100..mu..Ci I/sup 123/ (12 pts) or 15 min after iv 450..mu..Ci Tc/sup 99m/ (5 pts), followed by background image in Tl 80 KeV 20% window, followed by 3 additional images immediately after iv 2.0mCi Tl. The collimator was 6 cm from anterior surface of neck. Ultrasound (U/S) was done in 13 pts. Criteria for abnormal dual tracer test indicative of PT hyperplasia or adenoma was any definable mismatched Tl uptake compared to I/sup 123/ or Tc image, or eccentric or extrathyroidal Tl uptake. Under optimal circumstances, knowing results of U/S and surgery, 2 observers analyzed data from computer display. Fifty-two PT glands were examined by surgery; Tl detected 12/13 adenomas, 6/11 hyperplasia; however, there was abnormal Tl uptake in the region of 16/28 normal PT glands. Thyroid disease was demonstrated in 13/16 of these at surgery or U/S. False positive uptake was more common in pts with abnormal thyroid image (8/13) than in pts with normal appearing thyroid (1/4). Even using the most stringent criteria, false positive uptake was misleading with respect to the presence or site of PT adenoma in 6 pts. More PT adenoma were positive on dual Tl study (12/13) than on U/S (9/12); however, the low specificity of the dual tracer study indicates that as a prospective test the tracer technique should not be the primary or sole imaging modality for detection of PT disease.
- Research Organization:
- Massachusetts General Hospital, Boston, MA
- OSTI ID:
- 6593357
- Report Number(s):
- CONF-840619-; TRN: 87-018939
- Journal Information:
- J. Nucl. Med.; (United States), Vol. 25:5; Conference: 31. annual meeting of the Society of Nuclear Medicine, Los Angeles, CA, USA, 5 Jun 1984
- Country of Publication:
- United States
- Language:
- English
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DUAL-ISOTOPE SUBTRACTION TECHNIQUE
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GAMMA CAMERAS
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550601* - Medicine- Unsealed Radionuclides in Diagnostics